[Federal Register Volume 67, Number 40 (Thursday, February 28, 2002)]
[Notices]
[Pages 9281-9289]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-4772]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 02045]


Cardiovascular Health Programs; Notice of Availability of Funds

A. Purpose

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 2002 funds for a cooperative agreement 
for Cardiovascular Health (CVH) Programs. The cardiovascular diseases 
(CVD) to be addressed are primarily heart disease and stroke. This 
program addresses the ``Healthy People 2010'' focus area of Heart 
Disease and Stroke and associated risk factors (e.g., tobacco use, high 
cholesterol, high blood pressure, physical inactivity, and poor 
nutrition).
    The Centers for Disease Control and Prevention, National Center for 
Chronic Disease Prevention and Health Promotion (NCCDPHP) is issuing 
this Program Announcement in an effort to simplify and streamline the 
grant pre- and post-award administrative process, provide increased 
flexibility in the use of funds, measure performance related to each 
grantee's stated objectives and identify and establish the long-term 
goals of a CVH program through stated performance measures. Some 
examples of the benefits of the streamline process are: elimination of 
separate documents (continuation application and semi-annual progress 
report) to issue a continuation award; consistency in reporting 
expectations; elevation to a Comprehensive Program based on performance 
when funds are available; and increased flexibility within approved 
budget categories.
    Existing grantees under Program Announcement numbers 98084 or 00091 
will have their grant project periods extended to FY 2007 upon receipt 
of a technically acceptable application. Other eligible applicants will 
have an opportunity to compete for funding.
    The purpose of the program is to assist States in developing, 
implementing, and evaluating cardiovascular health promotion, disease 
prevention, and control programs and eliminating health disparities; 
and to assist States in developing their Core Capacity Programs into 
Comprehensive Programs. Core Capacity Programs are the foundation upon 
which comprehensive cardiovascular health programs are built. (See 
Logic Model for the State Cardiovascular Health program in Attachment I 
Background and Attachment III Performance Measures for a Comprehensive 
Program) in the application kit.
    To improve the cardiovascular health of all Americans, every State 
health department should have the capacity, commitment, and resources 
to carry out a comprehensive cardiovascular health promotion, disease 
prevention and control program (See Attachment II Core Capacity and 
Comprehensive Program Descriptions) in the application kit.

B. Eligible Applicants

    Assistance will be provided only to the health departments of 
States or their bona fide agents, including the Commonwealth of Puerto 
Rico, the Virgin Islands, the Commonwealth of the Northern Mariana 
Islands, American Samoa, Guam, the Federated States of Micronesia, the 
Republic of the Marshall Islands, and the Republic of Palau, under a 
competitive review process.
    States currently receiving CDC funds for Core Capacity Programs 
under Program Announcements 98084 or 00091, entitled State 
Cardiovascular Health Programs, are eligible to apply for Core Capacity 
or Comprehensive Program funding.
    The following 22 Core Capacity States/Health Departments are 
eligible to apply for Core Capacity or Comprehensive Program funding:
    Alabama, Alaska, Arkansas, Colorado, Connecticut, District of 
Columbia, Georgia, Illinois, Kentucky, Louisiana,

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Massachusetts, Minnesota, Mississippi, Montana, Nebraska, Ohio, 
Oklahoma, Oregon, Tennessee, Utah, West Virginia, and Wisconsin.
    States currently receiving CDC funds for Comprehensive Programs 
under Program Announcements 98084 or 00091, entitled State 
Cardiovascular Health Programs, are eligible to apply for Comprehensive 
Program funding only.
    The following 6 Comprehensive Program States/Health Departments are 
eligible to apply for Comprehensive Program funds only:
    Commonwealth of Virginia, Maine, Missouri, New York, North 
Carolina, and South Carolina Health Departments.
    All applications received from current grant recipients under 
Program Announcements 98084 or 00091 will be funded for either Core 
Capacity or Comprehensive Programs, pending approval of a technically 
acceptable application.
    Applications for Comprehensive funding received from current grant 
recipients that are not funded will continue with Core Capacity 
funding.
    As a contingency, currently funded Core Capacity recipients should 
provide a separate Core Work plan, budget, and budget justification 
that address Core Capacity recipient activities to expedite the award 
process.
    State health departments are uniquely qualified to define the 
cardiovascular disease problem throughout the State, to plan and 
develop statewide strategies to reduce the burden of CVD, to provide 
overall State coordination of cardiovascular health promotion, disease 
prevention, and control activities among partners, lead and direct 
communities, to direct and oversee interventions within overarching 
State policies, and to monitor critical aspects of CVD.

    Note: Title 2 of the United States Code section 1611 states that 
an organization described in section 501(c)(4) of the Internal 
Revenue Code that engages in lobbying activities is not eligible to 
receive Federal funds constituting an award, grant or loan.

C. Availability of Funds

    Approximately $16,000,000 is available in FY 2002 to fund 
approximately 31 awards. Approximately $6,700,000 is available to fund 
22 existing Core Capacity Programs grantees under Program Announcement 
numbers 98084 and 00091. It is expected that the average award will be 
$300,000, ranging from $250,000 to $400,000. Approximately $7,300,000 
is available to fund 6 existing Comprehensive Programs grantees under 
Program Announcement 98084 and 00091. It is expected that the average 
award will be $1,000,000, ranging from $850,000 to $1,400,000.
    Approximately $1,000,000 is available in FY 2002 for one or two 
existing Core Capacity Programs grantees under Program Announcement 
numbers 98084 and 00091 to receive Comprehensive level funding.
    In addition, approximately $1,000,000 is available in FY 2002 to 
fund one to three new Core Capacity Programs or approximately one new 
Comprehensive Program. Requests for these funds will be competitive and 
will be reviewed by an independent objective review panel. It is 
expected that the average award will be $300,000, ranging from $250,000 
to $400,000 for new Core Capacity Programs. It is expected that the 
average award will be $1,000,000, ranging from $850,000 to $1,400,000 
for new Comprehensive Programs. It is expected that Core Capacity and 
Comprehensive Program awards under this Program Announcement will begin 
on or about June 30, 2002 and will be made for a 12-month budget period 
within a project period of up to five years. Funding estimates may 
change.
    Applicants should submit two (2) separate budgets in response to 
this Program Announcement: (1) A detailed budget and narrative 
justification that supports the activities for year one funding in 
response to this Program Announcement for FY 2002 support, and (2) a 
categorical budget consistent with budget Form 424A for each year 2 
through 5 that describes the financial resources that would be needed 
for these funding years to fully fund a Cardiovascular Health program 
over a five-year project period.
    Continuation awards within an approved project period will be made 
on the basis of satisfactory progress as evidenced by required progress 
reports and the availability of funds.

1. Use of Funds

    Cooperative agreement funds may be used to support personnel and to 
purchase equipment, supplies, and services directly related to program 
activities and consistent with the scope of the cooperative agreement. 
Funds provided under this Program Announcement are not intended to be 
used to conduct research projects. Cooperative agreement funds may not 
be used to supplant State or Local funds. Cooperative agreement funds 
may not be used to provide patient care, personal health services, 
medications, patient rehabilitation, or other cost associated with the 
treatment of CVD. Although public health may have an assurance role in 
health screening, it is not recommended that these funds be used to 
provide health screening.
    As part of the increased flexibility efforts, applicants are 
encouraged to maximize the public health benefit from the use of CDC 
funding within the approved budget line items and to enhance the 
grantee's ability to achieve stated goals and objectives and to respond 
to changes in the field as they occur within the scope of the award. 
Recipients also have the ability to redirect up to 25 percent of the 
total approved budget or $250,000, whichever is less, to achieve stated 
goals and objectives within the scope of the award except from 
categories that require prior approval such as contracts, change in 
scope, and change in key personnel. A list of required prior approval 
actions will be included in the Notice of Grant Award.
    Applicants are encouraged to identify and leverage opportunities, 
which will also enhance the recipient's work with other State health 
department programs that address related chronic diseases or risk 
factors. This may include cost sharing to support a shared position 
such as Chronic Disease epidemiologist, health communication 
specialist, program evaluator, or policy analyst to work on risk 
factors or other activities across units/departments within the State 
health department. This may include, but is not limited to, joint 
planning activities, joint funding of complementary activities based on 
program recipient activities, coalition alliances and joint public 
health education, combined development and implementation of 
environmental, policy, systems, or community interventions and other 
cost sharing activities that cut across Chronic Disease Programs and 
related to recipient program activities.

2. Recipient Financial Participation

    Under the Comprehensive Program of this Program Announcement, 
matching funds are required from State sources in an amount not less 
than $1 for each $5 of Federal funds awarded. Applicants for the 
Comprehensive Program must provide evidence of State-appropriated 
resources targeting cardiovascular health promotion, disease 
prevention, and control of at least 16 percent of the total approved 
budget. A cost sharing or match requirement may not be met by costs 
borne by another federal grant. For example, the Preventive Health and 
Health Services (PHHS) Block Grant may not be included as State 
resource evidence.

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D. Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for conducting the activities under 
1.a. (Recipient Activities for Core Capacity Programs), 1.b. (Recipient 
Activities for Comprehensive Programs), and CDC will be responsible for 
the activities listed under 2. (CDC Activities). For all Core Capacity 
and Comprehensive Program Recipient Activities, efforts to address 
tobacco use, poor nutrition, physical inactivity, diabetes and school 
health should be coordinated with State tobacco, nutrition, physical 
activity, diabetes and coordinated school health programs; activities 
of these programs should not be duplicated.

1.a. Recipient Activities for Core Capacity Programs

(1) Develop and Coordinate Partnerships
    Identify, consult with, and appropriately involve State 
cardiovascular health partners to identify areas critical to the 
development of a State level cardiovascular health promotion, disease 
prevention, and control program, coordinate activities, avoid 
duplication of effort, and enhance the overall leadership of the State 
with its partners. Within the State health department, coordinate and 
collaborate with partners such as tobacco, nutrition, physical 
activity, secondary prevention, diabetes, school health, health 
education, PHHS Block Grant, state minority health liaison, office on 
aging, public information officer, laboratory, as well as with data 
partners such as vital statistics and the State's Behavioral Risk 
Factor Surveillance System (BRFSS). Within State government, 
collaborate and partner with other departments such as education, 
transportation, agriculture, agency on aging, parks and recreation and 
with State agency data partners, such as the Youth Risk Behavioral 
Surveillance System (YRBSS).
    Within the State, collaborate with organizations that address heart 
disease and stroke or related risk factors (e.g., tobacco use, high 
cholesterol, high blood pressure, physical inactivity, and poor 
nutrition) such as the American Heart Association, Biking and Walking 
Federation, smoke-free coalitions, Federally Qualified Health Centers, 
State Quality Improvement Organization, State medical society, and 
association of managed care organizations. Partners should also include 
organizations that improve health and quality of life (e.g., smart 
growth coalition) or provide access to a setting (e.g., business 
coalition on health) or a Priority Populations (e.g., State black 
nurses' association, association of Hispanic congregations, State 
Indian health boards). Partnerships and collaborative efforts may 
develop into memorandums of agreement (MOA) or similar formalized 
arrangements. The State health department should organize a statewide 
work group with representation from many of the groups mentioned above 
as well as other agencies, professional and voluntary groups, academia, 
community organizations, the media, and the public to develop a 
comprehensive CVH State plan.
(2) Develop Scientific Capacity To Define the Cardiovascular Disease 
Burden
    Enhance chronic disease epidemiology, statistics, monitoring, and 
data analysis from existing data systems such as vital statistics, 
hospital discharges, BRFSS and YRBSS. This should include the 
collection of cardiovascular-related data using the BRFSS protocols and 
time line. It is recommended that, as an essential element of defining 
the burden, funded States collect data on the BRFSS sections or modules 
on Hypertension Awareness, Cholesterol Awareness, and Cardiovascular 
Disease in odd years (i.e., 2003, 2005).
    It is recommended that funded States collect data using the Module 
on Heart Attack and Stroke Signs and Symptoms in 2005 and every four 
years after 2005 as a minimum. It is recommended that State CVD burden 
data be analyzed for program planning at least every two years or as 
needed and that a CVD Burden document be published every five years. 
The enhanced scientific capacity should include efforts to determine:
    (a) Trends in cardiovascular diseases, including age of onset of 
disease and age at death.
    (b) Geographic distribution of cardiovascular diseases.
    (c) Disparities in cardiovascular diseases and related risk factors 
by race, ethnicity, gender, geography, and socio-economic status.
    (d) Ways to integrate systems to provide comprehensive data needed 
for assessing and monitoring the cardiovascular health of populations 
and for program planning and assessment of program outcomes.
    Monitoring and program evaluation are considered essential 
components of building scientific capacity.
    The evaluation plan should address measures considered critical to 
determine the success of the program in meeting the required program 
activities, and program results should be used for program improvement. 
Evaluation should also address implementation of required program 
activities.
(3) Develop an Inventory of Policy and Environmental Strategies
    Develop an assessment of existing polices and environmental 
supports related to CVD risk factors (e.g., tobacco use, high 
cholesterol, high blood pressure, physical inactivity, and poor 
nutrition) and related conditions (e.g., diabetes and obesity). 
Information from the assessment or environmental scan should be used 
for program planning and priority setting related to key polices and 
environmental supports to be addressed by the CVH State program. For 
example, if the inventory shows that the State has policies restricting 
tobacco use in public buildings, then the CVH State program might not 
focus on this policy issue.
    The inventory would assess public policies (e.g., State policies, 
regulations, and legislation), as well as organizational policies 
(e.g., policies in schools, worksites, health care, and communities). 
The inventory should address the needs of Priority Populations, and 
should focus on primary and secondary prevention of cardiovascular 
diseases and related risk factors (e.g., tobacco use, high cholesterol, 
high blood pressure, physical inactivity, and poor nutrition) and 
related conditions (e.g., diabetes and obesity). The initial focus of 
the inventory should be on assessing policies at the State level that 
have an impact on settings: schools, worksites, health care, and 
communities (e.g., State legislation or Department of Education polices 
that may affect CVH-related policies in schools (see www.cdc.gov/nccdphp/dash/shpps for school policy data), State-level agency policies 
which affect whether a percentage of highway funds are dedicated to 
transportation alternatives which encourage people to be physically 
active, and association policies that provide guidance for use of 
accepted guidelines for the prevention and control of CVD in health 
care settings. During the project period, the inventory should assess 
supports at the State-level and then at other levels (e.g., district, 
local) for each of the four settings (e.g., schools, worksites, health 
care, and communities).
    Items inventoried could include issues related to food service 
policies; availability of environmental strategies for being active 
such as recreation centers, parks, walking trails; and restrictions on 
tobacco use. Health care-related policy and environmental issues

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should relate to the guidelines on standards of care for primary and 
secondary prevention and should be assessed in collaboration with the 
State Quality Improvement Organization, purchasers of medical care, 
managed care organizations, and consumers.
(4) Develop or Update a CVH State Plan
    Develop or update a comprehensive State Plan for cardiovascular 
health promotion, disease prevention, and control to include specific 
objectives for future reductions in heart disease and stroke and 
related risk factors and the promotion of heart health. Develop a 
thorough description of the cardiovascular disease burden 
geographically and demographically, set objectives, and include 
population-specific strategies for achieving the objectives. The 
strategies should emphasize population-based policy and environmental 
approaches and education as well as the increased awareness of signs 
and symptoms of primarily heart attack and stroke. It should address 
the needs of Priority Populations. The strategies may also include 
planning for program development within settings, particularly 
culturally appropriate strategies to reach Priority Populations. 
Partners should be involved in the development and implementation of 
the cardiovascular health State Plan. The CVH State Plan may be a stand 
alone plan or an identifiable section within another State plan.
(5) Provide Training and Technical Assistance
    Increase the skill-level of State and local health department staff 
and partners in areas such as population-based interventions, policy 
and environmental strategies, CVD and related risk factors (e.g., 
tobacco use, high cholesterol, high blood pressure, physical 
inactivity, and poor nutrition), secondary prevention, communication, 
epidemiology, cultural competence, use of data in program planning, and 
program planning and evaluation. Training may include provision of 
technical assistance to communities, worksites, health care sites, 
schools, and faith-based organizations.
(6) Develop Population-Based Strategies
    Develop plans for population-based intervention strategies to 
promote cardiovascular health, primary and secondary prevention of 
cardiovascular diseases and related risk factors (e.g., tobacco use, 
high cholesterol, high blood pressure, physical inactivity, and poor 
nutrition); increase awareness of signs and symptoms of primarily heart 
attack and stroke, educate about the need for policy and environmental 
approaches, and reduce the burden of cardiovascular diseases in the 
State. The strategies may include working with State-level 
organizations, health systems, worksites, schools, media, community 
organizations, non-traditional partners and government agencies as 
effective means to reach people.
    System changes are encouraged in four settings: schools, worksites, 
health care, and communities. Interventions within systems are 
encouraged at the highest level possible, for example, activities with 
business coalitions and unions rather than individual worksites and 
with managed care organizations (MCOs) and State medical associations 
rather than individual healthcare settings or physicians. Information 
regarding the CVD burden in the State and information from the 
inventories should be used to identify priority areas for 
interventions.
(7) Develop Culturally-Competent Strategies for Priority Populations
    Develop plans for enhanced program efforts to address Priority 
Populations. Specify how interventions would be designed appropriately 
for the Priority Populations to be addressed. Strategies should focus 
on policy and environmental approaches specific for the population to 
be addressed but may, on a limited basis, include interventions such as 
community events and campaigns designed to increase awareness of the 
cardiovascular disease burden and risk factors (e.g., tobacco use, high 
cholesterol, high blood pressure, physical inactivity, and poor 
nutrition) in the Priority Populations and to promote policy and 
environmental strategies to improve cardiovascular health and reduce 
risk factors. Initiatives may be used to demonstrate the effectiveness 
of selected strategies or as a means to generate community support for 
policy and environmental strategies.

1.b. Recipient Activities for Comprehensive Programs

    In addition to continuing and enhancing the Recipient Activities 
for Core Capacity Programs, Activities 1-5, Comprehensive Program will:
(1) Implement Population-Based Intervention Strategies Consistent With 
the State Plan
    Strategies should include policy and environmental approaches, 
education and awareness supportive of the need for policy and 
environmental approaches, and other population-based approaches. 
Priority intervention strategies include changes in policies and 
physical and social environments or settings to make the settings 
supportive of heart health and the prevention of CVD. Priority 
education and awareness strategies would include communication efforts 
to address CVD and risk factors, need for policy and environmental 
approaches and awareness of signs and symptoms, primarily of heart 
attack and stroke. The CDC Cynergy, CVH edition, is a communication 
planning tool in CD-ROM format that may be used by States to plan 
health communication activities within a public health context.
    These strategies/interventions may be disseminated through various 
settings and groups including State-level organizations, health care 
systems, worksites, schools, community organizations, governments, and 
the media. Interventions should be population-based, with objectives 
established that specify the population-wide changes sought. Approaches 
should emphasize State-level activities that bring about policy and 
environmental systems changes. Any approach should extend to a 
relatively large proportion of the population to be addressed, rather 
than a few selected communities. Interventions should be coordinated 
such that health messages, policies, and environmental measures are 
consistent, the most cost-effective methods are used for reaching the 
populations, and duplication of effort is avoided. Interventions should 
address tobacco use, elevated blood pressure, elevated cholesterol, 
physical inactivity, poor nutrition, diabetes, and secondary 
prevention. Implementation may extend to grants and contracts with 
local health agencies, communities, and nonprofit organizations.
(2) Implement Strategies Addressing Priority Populations
    These strategies may include interventions directed to specific 
communities and segments of the population, and may include all 
appropriate modes of interventions needed to reach the populations to 
be addressed. These strategies may include more intensive, directed 
interventions by organizations concerned with improving the health and 
quality of life of Priority Populations, including State-level 
organizations, work sites, health care sites, communities, and schools. 
Priority intervention strategies include changes in policies and 
physical and social environments or settings to make the settings 
supportive of heart health and the prevention of CVD. Priority 
education and awareness strategies

[[Page 9285]]

should include health communication efforts to address CVD and risk 
factors, need for policy and environmental approaches and awareness of 
signs and symptoms, primarily of heart attack and stroke.
(3) Specify and Evaluate Intervention Components
    Design and implement a program evaluation system. The evaluation 
plan should address measures considered critical to determine the 
success of the program, and evaluation results should be used for 
program improvement. Evaluation should be limited in scope to address 
strategy implementation, changes in policies and the physical and 
social environments affecting cardiovascular health. Evaluation should 
not include comparison communities or quasi-experimental designs. 
Evaluation should cover both population-based strategies as well as 
targeted strategies focused on Priority Populations. Evaluation should 
rely primarily upon existing data systems.
(4) Implement Professional Education Activities
    Provide or collaborate with partners to provide professional 
education to health providers and others to assure appropriate 
standards of care for primary and secondary prevention of CVD are 
offered routinely to all.
(5) Collaborate on Secondary Prevention Strategies
    Secondary prevention activities should be integrated into such 
things as partnerships, policy and environmental changes, and training 
and education in areas such as hypertension, high cholesterol, stroke, 
heart attack, diabetes, and congestive heart failure to ensure that 
recognized guidelines for secondary guidelines are followed. Activities 
in secondary prevention should include monitoring the delivery of 
secondary prevention practices (e.g., drug therapy, physical activity 
regimens, dietary changes, and hypertension and lipid management) and 
collaborating with partners on professional education and policy and 
practice change related to the implementation of the guidelines on 
standards of care for CVD. Development of monitoring systems and 
implementation of approaches for secondary prevention practices should 
be coordinated with partners such as the State Quality Improvement 
Organization, Federally Qualified Health Centers, managed care 
providers, Medicaid, major employers, insurers, other organized health 
care providers, and purchasers of health care. Secondary prevention 
strategies may be integrated with professional education initiatives.

2. CDC Activities

    a. Provide technical assistance in the coordination of monitoring 
and other data systems to measure and characterize the burden of 
cardiovascular diseases. Provide technical assistance in the design of 
monitoring instruments and sampling strategies, and provide assistance 
in the processing of data for States. Provide data on populations at 
highest risk. Provide data for national-level comparisons.
    b. Collaborate with the States and other appropriate partners to 
develop and disseminate programmatic guidance and other resources for 
specific interventions, media campaigns, and coordination of 
activities.
    c. Collaborate with the States and other appropriate partners to 
develop and disseminate recommendations for policy and environmental 
interventions including the measurement of progress in the 
implementation of such interventions.
    d. Collaborate with appropriate public, private, and nonprofit 
organizations to coordinate a cohesive national program.
    e. Provide technical assistance to the State public health 
laboratory or contract laboratory to standardize cholesterol, high 
density lipoproteins, and triglyceride measurements.
    f. Provide training and technical assistance regarding the 
coordination of interventions, policy and environmental strategies, and 
population-based strategies.

E. Content

Applications

    Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. Your application will be evaluated using the 
criteria listed, so it is important to follow them in laying out your 
program plan. Applications for the Core Capacity Program should not 
exceed 52 double-spaced pages, printed on one side, with one inch 
margins, in 12-point font, excluding budget, justification, and 
appendixes. Applications for the Comprehensive Program should not 
exceed 90 double-spaced pages, printed on one side, with one inch 
margins, in 12-point font, excluding budget, justification, and 
appendixes. All applicants should also submit appendices including 
resumes, job descriptions, organizational chart, facilities, and any 
other supporting documentation as appropriate. All materials must be 
suitable for photocopying (i.e., no audiovisual materials, posters, 
tapes, etc.).
    Applicants may apply for funding of either Core Capacity Program or 
Comprehensive Program, but not both, and must designate in the 
Executive Summary of their application the component (Core Capacity 
Program or Comprehensive Program) for which they are applying. Provide 
the following information:
1. Executive Summary
    All applicants must provide a summary of the program described in 
the proposal (two pages maximum
2. Core Capacity Program
    (Application portion of the Core Capacity Program application may 
not exceed 50 double-spaced pages using 12-point font):
    a. Staffing (not included in 50-page limitation). Describe program 
staffing and qualifications including access to expertise in tobacco, 
physical activity, nutrition, secondary prevention, epidemiology, and 
evaluation. Provide organizational chart, resumes, job descriptions, 
and experience for all budgeted positions. Describe lines of 
communication between various related chronic disease programs and risk 
factors. It is recommended that staff include a full-time program 
manager and a one-half time chronic disease epidemiologist. Assurance 
should be given that staff have the skills to carry out Recipient 
Activities, such as program development, health education, and 
partnership development.
    b. Facilities (not included in 50-page limitation). Describe 
facilities and resources available to the program, including equipment 
available, communications systems, computer capabilities and access, 
and laboratory facilities if appropriate.
    c. Background and Need. Describe the need for funding and the 
current resources available for Core Capacity activities, to include:
    (1) The overall State cardiovascular disease problem.
    (2) The geographic patterns, trends, age, gender, racial and ethnic 
patterns, and other measures or assessments.
    (3) The barriers the State currently faces in developing and 
implementing a Statewide program for the prevention of cardiovascular 
diseases.
    (4) The advisory groups, partnerships, or coalitions currently 
involved with the State health department for cardiovascular disease 
prevention and control, including the current chronic

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disease programs within the State health department and present 
linkages with those programs.
    (5) The gaps in resources, staffing, capabilities, and programs 
that, if addressed, might further the progress of cardiovascular 
disease prevention.
    d. Core Capacity Work Plan. Provide a work plan that addresses each 
of the required Core Capacity elements cited in the Recipient 
Activities section above, to include the following information:
    (1) Program objectives for each of the Recipient Activities. 
Objectives should describe what is to happen, by when, and to what 
degree.
    (2) The proposed methods for achieving each of the objectives.
    (3) The proposed partnerships and collaborations for achieving each 
of the objectives.
    (4) The proposed plan for evaluating progress toward attainment of 
the objectives.
    (5) A milestone, time line, and completion chart for all objectives 
for the project period.
    e. Core Capacity Program Budget. Provide a detailed line-item 
budget with justifications consistent with the purpose and proposed 
objectives, using the format on PHS Form 5161-1. Applicants are 
encouraged to include budget items for travel for two trips to Atlanta, 
Georgia for two individuals to attend a three-day training and 
technical assistance workshops.
    Supporting materials such as organizational charts, tables, 
position descriptions, relevant publications, letters of support that 
specify the type of support, MOA, etc., should be included in the 
appendixes and be reproducible. Materials included in the appendixes 
should be responsive to the Program Announcement. Including extensive 
materials is not recommended.
3. Comprehensive Program (Application portion of the Comprehensive 
Program application may not exceed 90 double-spaced pages using 12 
point font)
    a. Background and Need.
    (1) Provide evidence that the State health department has 
significant core capacity as specified in the Core Capacity Program 
Recipient Activities 1 through 5.
    (2) Provide a description of the overall burden of Cardiovascular 
disease and related risk factors in the State and the need for support 
in the State; the geographic and demographic distribution, age, sex, 
racial and ethnic groups, educational, and economic patterns of the 
diseases as well as the trends over time. Describe the key barriers to 
successful implementation of a statewide program for prevention of 
cardiovascular diseases within the State; partnerships and 
collaboration with related agencies, and the status of policies and 
environmental approaches in place that influence risk factors and 
public awareness. Provide a description of the populations to be 
addressed, including Priority Populations, and their constituencies and 
leadership potential to develop and conduct program activities.
    b. Staffing (not included in 90-page limitation). Describe project 
staffing and qualifications including access to expertise in tobacco, 
physical activity, nutrition, secondary prevention, evaluation, and 
epidemiology. Provide organizational chart, curriculum vitae, job 
descriptions, and experience needed for all budgeted positions. 
Describe lines of communication between various related chronic disease 
programs. It is recommended that staff include a full-time program 
manager and at least a one-half time chronic disease epidemiologist. 
Assurance should be given that staff have the skills to carry out 
Recipient Activities, such as program development, health education, 
partnership development, policy development, evaluation, and training.
    c. State Plan. Provide the current State plan (dated January 1997 
or later) that includes population-based policy and environmental 
strategies as well as strategies for implementing programs which 
utilize health care settings, worksites, the media, schools, and 
communities; and which includes strategies addressing specific Priority 
Populations and communities.
    d. Comprehensive Program Work Plan. Address briefly how each of the 
Core Capacity recipient activities, cited in the Recipient Activities 
section above will be continued and enhanced. Address each of the 
required Comprehensive Program recipient activities cited in the 
Recipient Activities section above in sufficient detail to describe the 
results expected and how the State will achieve the results. Objectives 
and strategies should be consistent with the State Plan and specify 
Priority Populations to be addressed, communities, or geographic areas 
of concern; complete listings of the policy and environmental changes 
sought to create heart-healthy environments for the population; other 
intervention strategies; coordination among State partners; and 
strategies for closing the gaps in cardiovascular disease disparities. 
Interventions should be expressed in terms of changes sought for the 
general population as well as changes in Priority Populations to be 
addressed. Population-based approaches should extend to a relatively 
large proportion of the State population rather than a few selected 
communities. Targeted strategies should clearly define the Priority 
Populations to be addressed. Objectives should describe what is to 
happen, by when, and to what degree. A milestone and activities 
completion chart or time line should be provided for all objectives for 
the project period.
    e. Evaluation. Provide a description of monitoring activities that 
include mortality, changes in environmental and policy indicators, and 
behavioral risk factors including statistically valid estimates for 
populations to be addressed. Describe the capability for special one-
time surveys to be conducted by the State. Describe how each of the 
program elements will be evaluated and which measures are considered 
critical to monitor for evaluating the success of the program. Describe 
the various existing data systems to be employed, how the systems might 
be adapted, and the specific program elements to be evaluated by those 
systems. Describe the schedules for data collection and when analyses 
of the data will become available.
    f. Collaboration. Provide letters of support describing the nature 
and extent of involvement by outside partners and coordination among 
State health department programs, other State agencies, and non-
governmental health and non-health organizations. Describe how the 
overall delivery of interventions for Priority Populations will be 
enhanced by these collaborative activities.
    g. Training Capability. Provide a description of training sessions 
for health professionals provided within the past three years. Include 
agendas, dates, professional status or occupation, and number of 
attendees. Provide other evidence of training capabilities deemed 
appropriate to the program.
    h. Comprehensive Program Budget Justification. Provide a line-item 
budget consistent with CDC Form 0.1246 along with appropriate 
justifications. Applicants are encouraged to include budget items for 
travel for two trips to Atlanta, Georgia for two individuals to attend 
a three-day training and technical assistance workshops. State matching 
funds should be listed on question 15 (estimated funding) of the 
application face page and Section C of the Budget Information 
worksheet.

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F. Submission and Deadline

Application

    Submit the original and two copies of CDC form 0.1246. Forms are 
available in the application kit and at the following Internet address: 
www.cdc.gov/od/pgo/forminfo.htm.
    On or before April 17, 2002, submit the application to the Grants 
Management Specialist identified in the ``Where to Obtain Additional 
Information'' section of this announcement.
    Deadline: Applications shall be considered as meeting the deadline 
if they are either:
    1. Received on or before the deadline date; or
    2. Sent on or before the deadline date and received in time for 
submission to the independent review group. (Applicants must request a 
legibly dated U.S. Postal Service postmark or obtain a legibly dated 
receipt from a commercial carrier or U.S. Postal Service. Private 
metered postmarks shall not be acceptable as proof of timely mailing.)
    Late: Applications which do not meet the criteria in 1. or 2. will 
be returned to the applicant.

G. Evaluation Criteria

    Each competitive application will be evaluated individually against 
the following criteria by an independent review group appointed by CDC. 
Applications received from grantees funded under Program Announcement 
number 98094 or 00091 will be reviewed by independent reviewers 
utilizing the Technical Acceptability Review (TAR) process.

Applications Received From

1. Core Capacity Program (Total 100 points)
    a. Staffing (10 Points).
    The degree to which the proposed staff have the relevant 
background, qualifications, and experience; and the degree to which the 
organizational structure supports staffs' ability to conduct proposed 
activities. The degree to which recommended staffing allow for needed 
skills. Confirmation of staffing that allows for one FTE program 
manager and .5 FTE of a chronic disease epidemiologist.
    b. Facilities (5 Points).
    The extent to which the applicant's description of available 
facilities and resources are adequate.
    c. Background and Need (15 Points).
    The extent to which the applicant identifies specific needs and 
resources available for Core Capacity activities. The extent to which 
the funds will successfully fill the gaps in State capabilities.
    d. Core Capacity Work Plan (60 Points).
    (1) (20 Points) The extent to which the plan for achieving the 
proposed activities appears realistic and feasible and relates to the 
stated program requirements and purposes of this cooperative agreement.
    (2) (20 Points) The extent to which the proposed methods for 
achieving the activities appear realistic and feasible and relate to 
the stated program requirements and purposes of the cooperative 
agreement.
    (3) (10 Points) The extent to which the proposed plan for 
evaluating progress toward meeting objectives and assessing impact 
appears reasonable and feasible.
    (4) (10 Points) The degree to which partnerships, within and 
external to the State health department, are demonstrated through 
documented and collaborative activities and letters of support that 
describe the nature and extent of involvement and commitment.
    e. Objectives (10 Points).
    The degree to which objectives are specific, time-phased, 
measurable, realistic, and related to identified needs, program 
requirements, and purpose of the program.
    f. Budget (Not Scored).
    The extent to which the budget appears reasonable and consistent 
with the proposed activities and intent of the program.
2. Comprehensive Program (Total 100 points)
    a. Background and Need (35 Points).
    (1) (25 points) The extent to which the applicant provides evidence 
that it has significant core capacity as specified in the Core Capacity 
Program Recipient Activities 1-5 (see Program Recipient Activities 
section).
    (2) (10 Points) The extent to which the applicant identifies 
specific needs in relation to geographic and demographic distribution 
of cardiovascular diseases with particular emphasis on Priority 
Populations; identifies trends in mortality and risk factors (e.g., 
tobacco use, high cholesterol, high blood pressure, physical 
inactivity, and poor nutrition) and related conditions (e.g., diabetes 
and obesity); identifies barriers to successful program implementation; 
describes current partnerships and collaborations; and describes 
existing policy and environmental influences in terms of their affect 
on public awareness and the risk factors (e.g., tobacco use, high 
cholesterol, high blood pressure, physical inactivity, and poor 
nutrition) for cardiovascular diseases.
    b. Staffing (10 points).
    The degree to which the proposed staff have the relevant 
background, qualifications, and experience; the degree to which the 
organizational structure supports staffs' ability to conduct proposed 
activities; the degree to which the recommended staffing and skills are 
addressed. Confirmation of staffing that allows for one FTE program 
manager and .5 FTE of a chronic disease epidemiologist.
    c. Comprehensive Work Plan (40 Points).
    (1) (20 Points) The extent to which the work plan addresses briefly 
how the Core Capacity recipient activities will be continued and 
enhanced and, in detail, how they will address the Comprehensive 
Program recipient activities. The extent to which the work plan 
addresses primary and secondary prevention of CVD and promotion of CVH, 
policy and environmental strategies, education and awareness, and other 
appropriate population-based approaches and the extent of program 
activities that appropriately use settings (e.g., schools, worksites, 
health care, and communities). The extent to which the plan identifies 
and addresses the needs of Priority Populations.
    (2) (15 Points) The degree to which the objectives are specific, 
time-phased, measurable, realistic, and relate to identified needs and 
purposes of the program, for both the general population as well as the 
Priority Populations. The extent to which the work plan for achieving 
the proposed activities appears realistic and feasible, is consistent 
with the State Plan, and relates to the stated program requirements and 
purposes of this cooperative agreement. The extent to which the plan 
addresses the needs of the State and the appropriateness of the planned 
interventions to the cardiovascular disease problem.
    (3) (5 Points) The extent to which collaboration with State 
tobacco, nutrition, physical activity, health promotion, data systems 
(BRFSS), diabetes, coordinated school health and other chronic disease 
programs and with external partners is used to deliver the program; the 
extent to which coordination with other State chronic disease programs 
and other State agencies enhances the cardiovascular disease program; 
and the extent of involvement of other organizations within the State 
in the implementation of the program.
    d. Training Capability (5 Points).
    The extent to which the applicant demonstrates the provision of 
training sessions for health professionals and provides evidence of 
other training

[[Page 9288]]

capabilities deemed appropriate to the program.
    e. Evaluation (10 Points).
    The extent to which the evaluation plan appears capable of 
monitoring progress toward meeting specific project objectives, 
assessing the impact of the program on the general population, 
assessing changes in the Priority Populations, monitoring utilization 
of secondary prevention strategies, and assessing the implementation of 
policy and environmental strategies.
    f. Budget (Not Scored).
    The extent to which the budget appears reasonable and consistent 
with the proposed activities and intent of the program. For the 
Comprehensive application, matching funds should be provided.

H. Other Requirements

Technical Reporting Requirements

    Provide CDC with original plus two copies of:
1. Semi-Annual Progress Reports
    The first report is due March 15, 2003, outlining the requirements 
under items a through e, and subsequent semi-annual reports will be due 
on the 15th of March each year through March 15, 2006. The second 
report is due 90 days after the end of the budget period, outlining the 
requirements under items a through c. Semi-annual progress reports 
should include the following information. (The March 15th semi-annual 
progress report and accompanying budget and budget justification will 
be used to process your continuation award):
    a. A succinct description of the program accomplishments/narrative 
and progress made in meeting each program objective during the first 
six months of the budget period (June 30 through December 31) and 
should consist of no more than 50 pages,
    b. The reason for not meeting established program goals and 
strategies to be implemented to achieve unmet objectives (see 
performance measures below),
    c. A description of any new objectives including the expected 
impact on the overall burden of cardiovascular diseases and related 
risk factors and method of evaluating effectiveness and,
    d. A one-year line item budget and budget justification, and
    e. For all proposed contracts, provide the name of contractor, 
period of performance, method of selection, method of accountability, 
scope of work, and itemized budget and budget justification. If the 
information is not available when the application is submitted, please 
indicate To Be Determined until the information is available. When the 
information becomes available, it should be submitted to the CDC 
Procurement and Grants Management Office contact identified in this 
Program Announcement.
    The semiannual progress report will be used as evidence of Core 
Capacity Program's attainment of Core Capacity goals and objectives and 
the program's readiness to compete for a Comprehensive Program award 
should funds be available. Core Capacity Program grantees wishing to 
compete for a Comprehensive Program, should submit an application that 
is responsive to the Core Capacity Performance Measures, Application 
Content and Recipient Activities section of this program announcement 
including a line item budget and budget justification. Competitive 
Comprehensive applications will be reviewed by CDC staff utilizing the 
Technical Acceptability Review (TAR) process. Applications can be 
submitted in fiscal year 2003, 2004, 2005, or 2006. Applications must 
be submitted (post mark) by March 15 of the fiscal in which the 
applicant wishes to be considered for Comprehensive funding.
    Funding decisions will be made on the basis of satisfactory 
progress on the Core Capacity Performance Measures as evidenced by 
required reports (semi-annual report), application score, and the 
availability of funds.
    Core Capacity Performance Measures include evidence that the 
applicant has significant core capacity as specified in the Core 
Capacity Program Recipient Activities 1-5.
    (1) Evidence of at least 8 diverse and active partnerships: 
documentation such as minutes of meetings that delineates partners 
leadership for completing tasks, lists of work group members, memoranda 
of understanding, outcomes or products of the partnership, training 
agendas, and other documents that demonstrate collaboration on CVH 
program activities with partners that include State health department 
programs, other States agencies, organizations that promote CVH or 
address CVD or related risk factors; organizations that improve health 
and quality of life, and organizations that address the needs of 
Priority Populations.
    (2) Evidence that the cardiovascular disease burden has been 
defined: provision of a CVD Burden Document (published in the past 
three years) or description of the burden of CVD and related risk 
factors, geographic and demographic distribution of CVD, including 
racial and ethnic disparities, and trends in CVD.
    (3) Evidence that an assessment of existing policy and 
environmental strategies has been completed for state-level 
organizations and groups that impact on the four settings (i.e., 
worksites, health care, schools, and communities) and performed at 
other levels (e.g., district, local) for at least 1 of the 4 settings; 
provision of summaries of the data collected and methods used.
    (4) Evidence that a comprehensive CVH State Plan has been 
developed: provision of the CVH State Plan that uses CVD burden data 
and other assessment data to identify priorities, addresses primary and 
secondary prevention of CVD and related risk factors; promotes CVH, 
population-based approaches, and policy and environmental strategies; 
addresses Priority Populations; and confirms that it was developed with 
the input of partners within and external to the State health 
department.
    (5) Evidence that training and technical assistance has been 
provided or coordinated by the State CVH Program within the state for 
State health department staff, local health department staff, and 
partners: provision of agendas, documents confirming training and 
assistance provided in at least 4 of the following priority areas 
(i.e., population-based interventions, policy and environmental 
strategies, CVD and related risk factors, secondary prevention, health 
communication, epidemiology, cultural competence, use of data in 
program planning, and program planning and evaluation).
    2. Financial status reports are due, no more than 90 days after the 
end of the budget period; and
    3. Final financial and performance reports are due, no more than 90 
days after the end of the project period.
    Send all reports to the Grants Management Specialist identified in 
the ``Where to Obtain Additional Information'' section of this 
announcement.
    The following additional requirements are applicable to this 
program. For a complete description of each, see Attachment IV in the 
application kit.

AR-7  Executive Order 12372 Review
AR-8  Public Health System Reporting Requirements
AR-9  Paperwork Reduction Act Requirements
AR-10  Smoke-Free Workplace Requirements
AR-11  Healthy People 2010
AR-12  Lobbying Restrictions

[[Page 9289]]

I. Authority and Catalog of Federal Domestic Assistance Number

    This program is authorized under section 301(a) and 317(k)(2) of 
the Public Health Service Act, (42 U.S.C. section 241(a) and 
247b(k)(2)), as amended. The Catalog of Federal Domestic Assistance 
number is 93.945.

J. Where To Obtain Additional Information

    This and other CDC announcements can be found on the CDC home page 
Internet address--http://www.cdc.gov. Click on ``Funding,'' then 
``Grants and Cooperative Agreements.''
    If you have questions after reviewing the contents of all the 
documents, business management technical assistance may be obtained 
from: Michelle Copeland, Grants Management Specialist, Grants 
Management Branch, Procurement and Grants Office, Centers for Disease 
Control and Prevention, 2920 Brandywine Road, Room 3000, Atlanta, GA 
30341-4146. Telephone number: 770-488-2686. E-mail address: 
[email protected].
    For program technical assistance, contact: Nancy B. Watkins, 
M.P.H., Team Leader for Program Services, Intervention and Evaluation 
Cardiovascular Health Branch, Centers for Disease Control and 
Prevention, Division of Adult and Community Health, 4770 Buford 
Highway, NE, MS K-47, Atlanta, GA 30341. Telephone number: 770-488-
8004. Fax: 770-488-8151. E-mail address: [email protected].

    Dated: February 22, 2002.
Robert L. Williams,
Chief, Acquisition and Assistance Branch B, Procurement and Grants 
Office, Center for Disease Control and Prevention (CDC).
[FR Doc. 02-4772 Filed 2-27-02; 8:45 am]
BILLING CODE 4163-18-P